Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...

00338050941 GENTAM/NACL INJ 80MG 12/31/9999 2012300409788313 GENTAM/NACL INJ 80MG 12/31/9999 2012300409788423 GENTAM/NACL INJ 80MG PB 12/31/9999 2012300168007115 GENTAMICIN CRE 0.1% 12/31/9999 2012345802005611 GENTAMICIN CRE 0.1% 12/31/9999 2012345802005635 GENTAMICIN CRE 0.1% 12/31/9999 2012363323017302 GENTAMICIN INJ 10MG/ML 12/31/9999 2012363323051302 GENTAMICIN INJ 10MG/ML 12/31/9999 2012300409120703 GENTAMICIN INJ 40MG/ML 12/31/9999 2012363323001002 GENTAMICIN INJ 40MG/ML 12/31/9999 2012363323001020 GENTAMICIN INJ 40MG/ML 12/31/9999 2012300168007815 GENTAMICIN OIN 0.1% 12/31/9999 2012345802004611 GENTAMICIN OIN 0.1% 12/31/9999 2012345802004635 GENTAMICIN OIN 0.1% 12/31/9999 2012348102010235 GENTAMICIN OIN 0.3% OP 12/31/9999 2012324208058060 GENTAMICIN SOL 0.3% OP 12/31/9999 2012324208058064 GENTAMICIN SOL 0.3% OP 12/31/9999 2012360758018805 GENTAMICIN SOL 0.3% OP 12/31/9999 2012361314063305 GENTAMICIN SOL 0.3% OP 12/31/9999 2012300078051816 GENTEAL DRO OPTH 12/31/9999 2012300078051824 GENTEAL DRO OPTH 12/31/9999 2012300078042516 GENTEAL GEL 12/31/9999 2012300078042524 GENTEAL GEL 12/31/9999 2012300078042947 GENTEAL GEL 0.3% 12/31/9999 2012300078042957 GENTEAL GEL 0.3% 12/31/9999 2012300078042997 GENTEAL GEL 0.3% 12/31/9999 2012300078051716 GENTEAL MILD DRO 0.2% 12/31/9999 2012300078051724 GENTEAL MILD DRO 0.2% 12/31/9999 2012300078047397 GENTEAL PM OIN 12/31/9999 2012315127000230 GENTLE LAXAT TAB 5MG EC 12/31/9999 2012349614013163 GENTLE LAXAT TAB 5MG EC 12/31/9999 2012311701001826 GENTLE RAIN LIQ ANTIBACT 12/31/9999 2012300049396041 GEODON CAP 20MG 12/31/9999 2012300049396060 GEODON CAP 20MG 12/31/9999 2012300049397041 GEODON CAP 40MG 12/31/9999 2012300049397060 GEODON CAP 40MG 12/31/9999 2012300049398041 GEODON CAP 60MG 12/31/9999 2012300049398060 GEODON CAP 60MG 12/31/9999 2012300049399041 GEODON CAP 80MG 12/31/9999 2012300049399060 GEODON CAP 80MG 12/31/9999 2012300049392083 GEODON INJ 20MG 12/31/9999 2012354838000780 GERIATON LIQ 12/31/9999 2012350383012016 GERI-TONIC LIQ 12/31/9999 2012318860025330 GESTICARE PAK DHA 12/31/9999 2012300121077504 GG/CODEINE SOL 100-10/5 12/31/9999 2012300121077516 GG/CODEINE SOL 100-10/5 12/31/9999 2012300121177505 GG/CODEINE SOL 100-10/5 12/31/9999 2012300121177510 GG/CODEINE SOL 100-10/5 12/31/9999 2012364376043516 GG/CODEINE SOL 100-10/5 12/31/9999 2012300093542328 GIANVI TAB 3-0.02MG 12/31/9999 2012300093542358 GIANVI TAB 3-0.02MG 12/31/9999 2012300603760817 GILDESS FE TAB 1.5/30 12/31/9999 2012300603760917 GILDESS FE TAB 1/20 12/31/9999 2012300078060751 GILENYA CAP 0.5MG 12/31/9999 2012351552121207 GINGER ROOT POW 12/31/9999 2012351552067204 GINKGO BILOB POW 12/31/9999 2012351552067205 GINKGO BILOB POW 12/31/9999 2012300944288401 GLASSIA INJ 12/31/9999 2012300078040134 GLEEVEC TAB 100MG 12/31/9999 2012300078043815 GLEEVEC TAB 400MG 12/31/9999 20123